Organization
INTEGRATIVE PERFORMANCE MEDICAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA BUATTE (OFFICE MANAGER)
(618) 659-8889
Entity
Organization
Contact information
Practice address
200 S BUCHANAN ST, EDWARDSVILLE, IL 62025-2109
(618) 659-8889
(618) 283-1101
Mailing address
200 S BUCHANAN ST, EDWARDSVILLE, IL 62025-2109
(618) 659-8889
(618) 283-1101
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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